Vascular risk factors in INPH
Vascular risk factors in INPH
复制标题
INPH 的血管危险因素
作者：
H. Israelsson;B. Carlberg;C. Wikkelsö;K. Laurell;B. Kahlon;G. Leijon;A. Eklund;J. Malm
目的：使用大样本的代表性INPH患者和基于人群的对照，评估特发性正常压力脑积水（INPH）的完整血管风险因素（VRF）特征，以确定血管疾病影响INPH病理生理学的程度。方法：将2008-2010年在瑞典接受分流术的所有INPH患者与年龄和性别匹配的人群对照进行比较。入选标准为年龄60-85岁，无痴呆。10个最重要的VRF和脑血管及周围血管疾病进行了前瞻性评估，使用血液样本，临床检查，和标准化的问卷调查。评估的VRF包括高血压、高脂血症、糖尿病、肥胖、心理社会因素、吸烟习惯、饮食、饮酒、心脏病和体力活动。结果：共有176例INPH患者和368例对照参与。多因素Logistic回归分析表明，高脂血症（比值比[OR] 2.380; 95%置信区间[CI] 1.434-3.950），糖尿病（OR 2.169; 95%CI 1.195-3.938）、肥胖（OR 5.428; 95%CI 2.502-11.772）和心理社会因素（OR 5.343; 95%CI 3.219-8.868）与INPH独立相关。高血压、缺乏体力活动、脑血管和外周血管疾病在INPH中的比例也过高。适度饮酒和体力活动在对照组中的比例过高。人群归因风险百分比为24%。结论：我们的研究结果证实，INPH患者有更多的VRF，缺乏一般人群中存在的保护因素。几乎25%的INPH病例可以由VRF解释。提示INPH可能是血管性痴呆的一个亚型。针对可变VRF的有针对性的干预措施可能对INPH产生有益影响。
Objective: To assess the complete vascular risk factor (VRF) profile of idiopathic normal pressure hydrocephalus (INPH) using a large sample of representative patients with INPH and population-based controls to determine the extent to which vascular disease influences INPH pathophysiology. Methods: All patients with INPH who underwent shunting in Sweden in 2008–2010 were compared to age- and sex-matched population-based controls. Inclusion criteria were age 60–85 years and no dementia. The 10 most important VRFs and cerebrovascular and peripheral vascular disease were prospectively assessed using blood samples, clinical examinations, and standardized questionnaires. Assessed VRFs were hypertension, hyperlipidemia, diabetes, obesity, psychosocial factors, smoking habits, diet, alcohol intake, cardiac disease, and physical activity. Results: In total, 176 patients with INPH and 368 controls participated. Multivariable logistic regression analysis indicated that hyperlipidemia (odds ratio [OR] 2.380; 95% confidence interval [CI] 1.434–3.950), diabetes (OR 2.169; 95% CI 1.195–3.938), obesity (OR 5.428; 95% CI 2.502–11.772), and psychosocial factors (OR 5.343; 95% CI 3.219–8.868) were independently associated with INPH. Hypertension, physical inactivity, and cerebrovascular and peripheral vascular disease were also overrepresented in INPH. Moderate alcohol intake and physical activity were overrepresented among the controls. The population-attributable risk percentage was 24%. Conclusions: Our findings confirm that patients with INPH have more VRFs and lack the protective factors present in the general population. Almost 25% of cases of INPH may be explained by VRFs. This suggests that INPH may be a subtype of vascular dementia. Targeted interventions against modifiable VRFs are likely to have beneficial effects on INPH.
零星大脑小血管疾病的机制：神经影像学的见解。
DOI：
10.1016/s1474-4422(13)70060-7
发表时间：
2013-05
期刊：
The Lancet. Neurology
影响因子：
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作者：
Wardlaw JM;Smith C;Dichgans M
通讯作者：
Dichgans M